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Cytoreductive surgery and heated intraperitoneal chemotherapy for peritoneal carcinomatosis secondary to mucinous adenocarcinoma of the appendix.
- Source :
-
International surgery [Int Surg] 2015 Jan; Vol. 100 (1), pp. 21-8. - Publication Year :
- 2015
-
Abstract
- Cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) is a radical but effective treatment option for select peritoneal malignancies. We sought to determine our early experience with this method for peritoneal carcinomatosis secondary to mucinous adenocarcinomas of appendiceal origin. As such, we performed a retrospective clinical study of 30 consecutive patients undergoing CRS with planned HIPEC at the Princess Alexandra Hospital, between June 2009 to December 2012, with mucinous adenocarcinomas of the appendix. CRS was performed in 30 patients, 13 received HIPEC intraoperatively and 17 received early postoperative intra-peritoneal chemotherapy (EPIC) in addition. Mean age was 52.3 years and median hospital stay was 26 days (range 12-190 days). Peritoneal cancer index scores were 0-10 in 6.7% of patients, 11-20 in 20% of patients and >20 in 73.3% of patients. Complete cytoreduction was achieved overall in 21 patients. In total, 106 complications were observed in 28 patients. Ten were grade 3-A, five were grade 3-B and one grade-5 secondary to a fatal PE on day 97. In patients who received HIPEC, there was no difference in disease-free survival (P = 0.098) or overall survival (P = 0.645) between those who received EPIC versus those who did not. This study demonstrates that satisfactory outcomes with regards to morbidity and survival can be achieved with CRS and HIPEC, at a single-centre institution with growing expertise in the technique. Our results are comparable with outcomes previously described in the international literature.
- Subjects :
- Adenocarcinoma, Mucinous mortality
Adenocarcinoma, Mucinous therapy
Adult
Aged
Antibiotics, Antineoplastic therapeutic use
Chemotherapy, Adjuvant
Female
Follow-Up Studies
Humans
Hyperthermia, Induced
Male
Middle Aged
Mitomycin therapeutic use
Peritoneal Neoplasms mortality
Peritoneal Neoplasms therapy
Retrospective Studies
Survival Analysis
Treatment Outcome
Adenocarcinoma, Mucinous secondary
Antibiotics, Antineoplastic administration & dosage
Appendiceal Neoplasms pathology
Chemotherapy, Cancer, Regional Perfusion methods
Cytoreduction Surgical Procedures
Mitomycin administration & dosage
Peritoneal Neoplasms secondary
Subjects
Details
- Language :
- English
- ISSN :
- 2520-2456
- Volume :
- 100
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- International surgery
- Publication Type :
- Academic Journal
- Accession number :
- 25594636
- Full Text :
- https://doi.org/10.9738/INTSURG-D-14-00089.1